Dear OncoLink "Ask The Experts,"
I have heard that if I choose radiation therapy for prostate cancer treatment that I could not have surgery later if the cancer recurs. Why not?
Alan J. Wein, MD, Professor and Chair of the Division of Urology at the University of Pennsylvania School of Medicine, responds:
You can have surgery after radiation therapy. The risks however, such as urinary incontinence, erection, rectal injury are very much higher and the actual cure rates (meaning no disease present at 10 to 15 years after surgery) are uncertain.
Daniel Eun MD ?Director of Robotic and Minimally Invasive Urologic Oncology and Reconstruction at PENN Urology at Pennsylvania Hospital, responds:
One of the most common questions posed to urologists surrounds the concept of limiting treatment options if one chooses radiation. It is true that radiation therapy can be administered to patients with either high-risk features at prostatectomy or detectable PSA following surgery. The question of surgery after radiation therapy is a bit more complicated. There are certainly centers that will perform surgery after radiation therapy; however, the morbidity (side-effects) associated with salvage prostatectomy (surgery after radiation) is significant, particularly with regard to erectlie dysfunction and urinary continence. Cryotherapy (freezing the prostate) remains an option for those patients who undergo radiation therapy who are thought to have local failure.
This question and answer was part of the OncoLink Brown Bag Chat Series. See the full transcript of Prostate cancer treatment: where are we now?